Prevalence of Depressive Disorder and Its Treatment Among Patients With Chronic Pain- A Cross Sectional Study

Abstract

BACKGROUND Depression coexisting with chronic pain can influence the course and prognosis of chronic pain due to any aetiology. Till the psychopathology remains unveiled and treated, rehabilitation process in chronic pain patients is incomplete. The studies addressing the treatment of depressive disorder in chronic pain are limited. MATERIALS AND METHODS Patients were recruited via simple randomization from Pain and Palliative clinic of Government Medical College, Thrissur. After obtaining informed consent, patients were assessed using a semi structured questionnaire to elicit socio-demographic information and medical data. VAS scale was used to assess the severity of pain. PHQ 9 Questionnaire was used as a screening tool for depression and ICD-10-Diagnostic Criteria for Research (DCR) for substantiating the diagnosis. Data was analysed in SPSS software using independent sample t test and chi square test. RESULTS The psychiatric morbidity was 48.8% for depression. There was significant association between sex-females having more depression (p<0.001) and marital status-the divorced, separated and spouse expired being more prone for depression (p<0.008). There was a significant association between psychiatric morbidity and pain variables (P <0.0001) including the duration and severity of pain. 21.68% of the depressed patients were getting antidepressants as adjuvant. Out of 18 patients with severe depression, only 3 patients were getting antidepressants as adjuvant. There was no association between age, education, occupation, aetiology of pain, and psychiatric morbidity. CONCLUSION The prevalence of depressive disorder patients with chronic pain of any cause is high. Depression is associated with increased pain perception, poly pharmacy and poor treatment outcome. While dealing with chronic pain, the risk of associated depressive disorder should be evaluated and managed properly.